د. عدنان الأدهل | البروتوكول العلاجي للحمى الروماتيزية

Rheumatic fever

• usually affects children with recurrent tonsilitis and pharyngitis or young adults (5-15 years).

• tonsilitis-pharyngitis are the most common cause of hematuria in children.

Causes:

• It is triggered by an immune-mediated delayed response to infection with B hemolytic streptococci.

Affects:

• Early in life lead to Arthritis.
• Lately in life lead to Valvitis (specially mitral valve).

🔸Jones criteria for the diagnosis of rheumatic fever:

1) Major manifestations:

               • Carditis

               • Polyarthritis

               • Chorea

               • Erythema marginatum

               • Subcutaneous nodules

2) Minor manifestations:

               • Fever

               • Arthralgia

               • Previous rheumatic fever

               • Raised ESR or CRP

               • Leucocytosis

               • First-degree AV block

Diagnosis of rheumatic fever depends on:

• two or more major criteria and one minor.
• one major and two or more minor creiteria.

🔸Treatment:

1) first treatment:

• Benzylpenicillin(1200,000 unit single dose /M.I).

2)Second treatment: "pain killers"

•      NSAIDs "ibuprofen"
•      Prednisolone.

*Aspirin is contraindicated for children, because may lead to Reye syndrome.

3)Third treatment: "Protection"

•      Benzathine pencillin (1200,000 I.M every month)

الدكتور / عدنان الادهل 

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